Annual Report for Domestic Non-Profit Corp
Prepared for:
[Client.FirstName][Client.LastName]
[Client.Company]
Created by:
[Sender.FirstName][Sender.LastName]
[Sender.Company]
Domestic Non-Profit Corporation
Corporation Name:
Date Incorporated:
[Sender.Company] INCORP Date
Entity Number:
FEIN:
Principal Place of Business (Physical Address):
Principle Business Street Address 1
Principle Business Street Address 2
Principle Business City, Principle Business State, Principle Zip
Mailing Address:
Mailing Address 1
Mailing Address 2
Mailing City, Mailing State, Mailing Zip
Name and address of Registered Agent:
Registered Agent
RA Street address 1
RA Street address 2
RA City, RA State, RA Zip
Officers and Directors:
President/CEO:
President
President Address 1
President Address 2
President City, President State, President Zip
Secretary:
Secretary
Secretary Address 1
Secretary Address 2
Secretary City, Secretary State, Secretary Zip
Treasurer/CFO:
Treasurer
Treasurer Address 1
Treasurer Address 2
Treasurer City, Treasurer State, Treasurer Zip
Director:
Director 1
Director 1 Address 1
Director 1 Address 2
Director 1 City, Director 1 State, Director 1 Zip
Director:
Director 2 Address 1
Director 2 Address 2
Director 2 City, Director 2 State, Director 2 Zip
Director:
Director 3
Director 3 Address 1
Director 3 Address 2
Director 3 City, Director 3 State, Director 3 Zip
I hereby certify under penalty of perjury of the laws of this state that the information listed above is true and correct to the best of my knowledge, and that I am an officer or director of this corporation with authority to sign and submit this report.
SIGN DATE:
[Sender.Company]
Signature
MM/DD/YYYY
[Sender.FirstName][Sender.LastName]
[Client.Company]
Signature
MM/DD/YYYY
[Client.FirstName][Client.LastName]
